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Repeal & Replace With What? GOP Still Short On Answers

From the editorial board of Anderson’s Independent Mail:

What will Republicans offer the American people if the party’s efforts to repeal health-care reform are successful?

“Replacing ‘Obamacare’ is not something we can do overnight,” Rep. Fred Upton, R-Mich., told the Washington Post. “It may take some time. But mark my words, we will get it done.” So far, however, all that has been accomplished (at least for the record) is the drafting of a resolution containing “broad, long-held GOP health-care goals” but no specifics — and the directing of four House committees to develop proposals.

The truth is, according to Fox News, the only plan the GOP has right now is to deny funding for the current plan. In a Feb. 8 story headlined “Republicans plan to choke off funding for health-care law,” the network reported that some House Republicans were eyeing the annual spending bill to pay for government operations as a way to “strip the health-care law of any dollars, thus depriving health-care operations of any money.”

Now that’s productive.

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Ignoring The People’s Will, House Blocks Reform Funds

The House-passed amendment takes aim at the Department of Health and Human Services. | AP Photo
From Politico:
2/18/11 3:09 PM EST

The House voted Friday to block funding for the health care law in several ways – starting the countdown to the defunding clash with Senate Democrats and President Barack Obama.

As expected, it approved Rep. Denny Rehberg’s amendment to the continuing resolution, which bans all payments to “any employee, officer, contractor, or grantee of any department or agency” to implement the law.

The Montana Republican’s amendment is aimed at the Department of Health and Human Services and the Labor Department.

But it also gave unexpected victories to Steve King of Iowa, approving broader measures to deny any implementation funds in the continuing resolution and block salaries to enforce the entire law.

And it approved another measure by Jo Ann Emerson of Missouri to block funding for the Internal Revenue Service to enforce the individual mandate – the wildly unpopular requirement for everyone to get health coverage starting in 2014.

None of the measures completely “defund” the health care law, because large sums of money are out of the reach of the spending bill. King lost an earlier bid, as expected, to cut off the roughly $105 billion that’s automatically appropriated under the law. It was struck down on a point of order, because it was considered legislating on an appropriations bill.

But taken together, they could add one more element of tension to the growing prospect of a government shutdown. That’s becoming a more realistic possibility if Obama, House Republicans and Senate Democrats can’t find common ground on the bill to fund the government for the rest of the fiscal year – and especially if they can’t agree on spending levels for a short-term extension to buy them some time.

The amendments won’t become law, as they’re written now, because they won’t get through the Democratic Senate. But they’ll be powerful bargaining chips when the House negotiates the final spending bill with the Senate — and probably with the administration, since Obama would have to sign it into law.

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Poll: Majority Disapproves Of Effort To Block Reform

From the Los Angeles Times:


February 16, 2011
By James Oliphant | Washington Bureau

Reporting from Washington — Even as Republicans attempt to de-fund the president’s healthcare overhaul on the House floor this week, a new poll suggests that they should proceed with caution.

The CBS News poll, conducted over the weekend, shows that although most Americans dislike the healthcare law, they also disapprove of the GOP’s attempts to cut off funding for the sweeping measure.

The seeming paradox is partially explained by a growing number of Americans — 44% — who are unsure about what the law actually does and doesn’t do. Some of the benefits of the law, such as a provision that permits post-college-age children to remain on their parents’ insurance plans, are already in operation. Others, such as state insurance exchanges, won’t be in place for at least two years.

After Republicans were unable to secure enough votes in the Senate earlier this month to repeal the healthcare law, their attention turned to de-funding it through the appropriations process.

With an extended debate underway in the House on a 2011 spending bill, Rep. Denny Rehberg (R-Montana) Wednesday introduced an amendment that would cut off all funding for the law.

“The House already passed legislation to repeal Obamacare, fulfilling the promise we made to the American people,” Rehberg said in a statement. ” My amendment prevents funding from being used to implement Obamacare while we continue to work for a full legislative or judicial repeal.”

Rehberg is running for the U.S. Senate seat in Montana held by Democratic Sen. Jon Tester.

According to the CBS poll, 51% of Americans surveyed disapproved of the law (compared with just 33% in favor), and 55% disapproved of the GOP’s de-funding plan, with 35% approving.

The biggest danger for the GOP? Forty-nine percent of independents, who will be crucial to Republican hopes for securing the White House and Senate in 2012, don’t like the idea of stripping out funding for the law.

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S.C. Fair Share’s Ruoff To The Rescue With Facts

From The Greenville News:

Critics Question Haley’s health Care Numbers

By Tim Smith • CAPITAL BUREAU • February 15. 2011

COLUMBIA — Advocates of a new federal health-care law are questioning the numbers and assertions by Gov. Nikki Haley and U.S. Sen. Lindsey Graham in pushing for legislation to allow states to “opt out” of the new law.

Graham, who has argued the new law would bankrupt South Carolina, and Haley, who also opposes the law, say Graham’s legislation would allow states to choose not to participate in some of the law’s most costly mandates, including Medicaid expansion.

“Medicaid is broken,” Graham said. “It should be reformed, not expanded to the point it would bankrupt the state of South Carolina.”

Haley, who told the Legislature last month the new law would cost $2.7 billion over 10 years, said Monday it would cost $3.2 billion. “We need to be focused on adding more jobs,” Haley said.

The $3.2 billion number and other assertions by Haley and Graham drew questions from advocates of the new law, including John Ruoff, program director for South Carolina Fair Share, an advocacy group. Ruoff said the new law will add between $470 million to $687 million in additional costs by 2019 depending on what study is used.

The $3.2 billion figures comes from an actuarial study done last year for the state’s chief Medicaid agency and is the total state impact through the year 2023, a spokesman for the agency said.

Ruoff said he believes the $470 million, though it is as of 2019, is the most realistic number because he said it is based on the addition of 344,000 to the state’s Medicaid rolls. He said if the state opts out of the new’s law’s mandates, it will be leaving $10 billion the law would bring to the state’s economy.

Frank Knapp, president of the South Carolina Small Business Chamber of Commerce, said one mandate has little relevance to the state. Almost 97 percent of the state’s businesses wouldn’t have to buy health insurance under the new law because they employ 50 or fewer workers, he said.

Gov. Haley: Let States Opt Out Of Health Care Law

Haley touts “tort reform” as magic bean for reforming health care “our way”- a lightweight policy prescription, at best.
By JIM DAVENPORT – Feb 14, 2011
By The Associated Press

COLUMBIA, S.C. (AP) — South Carolina Gov. Nikki Haley and U.S. Sen. Lindsey Graham said Monday they are backing federal legislation that would free states from mandates of the new national health care laws while advocates say they’re playing politics.

Graham said he’ll introduce a bill that will allow states to opt out of requirements that are at the heart of the new law, including mandates for individuals and businesses to buy coverage, as well as expansion of state Medicaid programs and minimum coverage requirements.

“There is a better way,” Graham said. “This bill allows the state of South Carolina to say ‘no’ to Washington when it comes to federally run, dominated health care.”

Haley said the federal law emphasizes health care services.

“What we need to be focused on is health — how do we get the most health for the least amount of money. If South Carolina does it right, we will actually reform health care our own way in our own state,” Haley said. “We need to be focused on adding more jobs. We don’t need to be focused on adding more Medicaid.”

In December, Haley asked President Barack Obama about ways to opt out of the federal law. Haley said Obama told her that if the state could operate a health care insurance exchange, allow insurance pools and bar insurers from denying coverage for pre-existing health care conditions, it might be able to opt out.

But looking into that so far suggested that about 175,000 people who now have employer insurance policies in South Carolina would instead get coverage through a Medicaid-backed plan, Haley said.

Graham’s legislation “is a surefire way of opting out in the way that we want to and not the way the president wants us to,” Haley said.

It doesn’t mean doing nothing, Haley said.

“First of all, we are absolutely going to do something in South Carolina, because health care is a strong issue in South Carolina that we care about,” Haley said. “But we’re going to do it our way. We’re going to do it through tort reform. We’re going to do it through jobs and education. We’re going to do it through Medicaid reform in the way that we look at how we manage our Medicaid dollars.”

South Carolina has already reformed its medical malpractice lawsuit system, said John Ruoff, program director for the advocacy group South Carolina Fair Share.

“How much more money are we going to save?” Ruoff asked.

Ruoff said South Carolina stands to create jobs with the federal health care law because more federal matching funds will be available for the state. Opting out would mean the state gives up $10.9 billion that would go to doctors, hospitals and other health care businesses. He said it raised questions about whether Graham and Haley were putting politics ahead of the state’s well-being.

And Frank Knapp, chief executive of the South Carolina Small Business Chamber of Commerce, said at least 96 percent of the businesses in South Carolina have fewer than 50 employees and wouldn’t be required to buy health insurance under the federal laws.

At the same time, new federal tax credits that encourage smaller employers to buy insurance are already working, Knapp said.

“Small businesses are not running away in fear,” he said. “They are taking and using the tax credits that are already in this bill.”

Senate Repeals Tax-Reporting Hassle For Small Business

Breathe easy. Headaches averted.

The Senate voted Wednesday for the first time to repeal a piece of President Barack Obama’s health care overhaul, rolling back a new tax reporting requirement that’s been universally panned by business owners.

The amendment to repeal the 1099 reporting requirement passed 81-17 with broad bipartisan support.

The provision was one that Obama identified in his State of the Union speech as something that Democrats were willing to change.

The Senate voted several times last year on repealing the requirement, but all the attempts failed amid partisan bickering over how to pay for it. Republicans made an attempt to repeal the provision by taking money from the health reform law’s prevention and wellness fund. Democrats tried to repeal it without paying for it.

The provision would have required business owners to file 1099 tax documents on all cumulative purchases from a single vendor that total more than $600 in a year.

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Reagan’s Solicitor General On Mandate’s Constitutionality

Former Reagan Solicitor General Charles Fried gave dispassionate testimony on Capitol Hill yesterday, right before Senate Democrats voted down repeal of the Affordable Care Act, articulating why he is “quite sure that the health care mandate is constitutional.”

SC DHHS Restores $13.8M In Cuts, Hospice Care

Health Agency To Halt Some Cuts In Services To Poor


Columbia resident Carolyn Stover said she was dismayed to learn last month that the state was cutting hospice care for her mother, Nellie.

Monday, Stover was thanking God and citing the power of prayer after state officials said they will continue to pay for that care.

The state Department of Health and Human Services said it will rescind a number of budget cuts that were to take effect today or in April, including eliminating state-paid hospice care.

The embattled state health agency, which pays for care for the poor, is running a deficit of more than $228 million at the same time the state is struggling with its own budget crisis — an $854 million revenue shortfall for the budget year that starts July 1.

The cutbacks that the health agency announced last month were intended to save $13.8 million. But the new head of Health and Human Services said Monday the cuts would have cost the state more money in the long run than they would have saved.

So, new agency director Tony Keck said the state will continue paying for hospice care, supplemental home-care services, nutritional supplements and 14 home-delivered meals a week, which it had proposed to cut to 10.

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White House Responds To Florida Ruling

The White House Blog

Judicial Activism and the Affordable Care Act

Posted by Stephanie Cutter on January 31, 2011 at 04:49 PM EST

Today, a judge in Florida issued a decision in a case filed by 25 Republican Attorneys General and Governors striking down the Affordable Care Act.   This ruling is well out of the mainstream of judicial opinion.   Twelve federal judges have already dismissed challenges to the constitutionality of the health reform law, and two judges – in the Eastern District of Michigan and Western District of Virginia – have upheld the law.   In one other case, a federal judge in the Eastern District of Virginia issued a very narrow ruling on the constitutionality of the health reform law’s “individual responsibility” provision and upheld the rest of the law.

Today’s ruling – issued by Judge Vinson in the Northern District of Florida – is a plain case of judicial overreaching.   The judge’s decision contradicts decades of Supreme Court precedent that support the considered judgment of the democratically elected branches of government that the Act’s “individual responsibility” provision is necessary to prevent billions of dollars of cost-shifting every year by individuals without insurance who cannot pay for the health care they obtain.  And the judge declared that the entire law is null and void even though the only provision he found unconstitutional was the “individual responsibility” provision.  This decision is at odds with decades of established Supreme Court law, which has  consistently found that courts have a constitutional obligation to preserve as a much of a statute as can be preserved. As a result, the judge’s decision puts all of the new benefits, cost savings and patient protections that were included in the law at risk.

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Health Law Suffers New Blow In Court

By JENNIFER HABERKORN | 2/1/11 4:38 AM EST Updated: 2/1/11 6:11 AM EST

The Obama administration is vowing to move full speed ahead with implementation of the health care reform law, even after a federal judge Monday declared the legislation unconstitutional.

It was the most striking blow yet to President Barack Obama’s signature domestic initiative, though it certainly won’t be the last ruling on the issue. The Justice Department plans to appeal. Judge Roger Vinson of the U.S. District Court of the Northern District of Florida ruled that the law’s requirement that nearly all Americans purchase health insurance is not within the legal bounds of Congress’s power under the commerce clause. But he stopped short of issuing an injunction to keep the federal government from enacting the law.

The administration called the ruling “well outside of the mainstream judicial opinion” and said implementation won’t change.

“I don’t think you should view this as the opening of the government shutting down the implementation effort,” a senior administration official said. The ruling is unlikely to derail implementation of the health reform law in the states. Each of the states that are party to the lawsuit has received some funding to implement provisions of the Affordable Care Act.

Even more conservative states concede that while they oppose the law, they would rather lay the groundwork themselves than cede control to the federal government. That’s the view of Rep. John Zerwas, a Republican in the Texas House of Representatives who introduced legislation to authorize his state to set up a health insurance exchange. “There’s one thing we know for sure: Health care reform is the law of the land,” he said Monday. “All of our efforts to declare it unconstitutional are aspirational at this point. I’d much rather be in a situation where we have a way to deal with this at a state level than have the federal government come in.”

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